Biomechanical Investigations of a New Model Graft Attachment to Distal Phalanx in Two-Stage Flexor Tendon Reconstruction
Year: 2025
Type: article
Abstract: Background/Objectives: In two-stage flexor tendon reconstruction, a biomechanically strong connection between the tendon graft, the motor unit, and the distal phalanx of the finger is essential to enable active rehabilitation after surgery. However, the available literature contains few biomechanical studies concerning the strength of this connection. In this study, we tested a new model of this connection involving suturing the tendon graft to the phalanx using an anchor and to the flexor digitorum profundus stump with a three-level continuous suture (palmaris longus—flexor digitorum profundus—anchor (PL-FDP-A)). Methods: For this study, we used eight fingers from patients with injuries that were unsuitable for replantation, as well as eight palmaris longus tendons harvested from cadavers. Eight specimens simulating the PL-FDP-A connections were prepared and tested on a tensile testing machine. The elongation of the specimens under a 20 N load (the minimum for active loading) and the force at rupture were assessed. Results: The mean rupture strength was 44.53 N (SD 16.27, min. 16.50, max. 64.60), with elongation at 20 N of 4.28 mm (SD 2.65, min. 1.49, max. 9.14). Conclusions: Based on our findings, we recommend the PL-FDP-A connection for use in two-stage flexor tendon reconstruction due to (1) rupture values which significantly exceeded the force required for active rehabilitation, and (2) minimal elongation at 20 N, so that motion transmission was not impaired.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm15010141
Authors: Tomasz Mazurek, Krzysztof Żerdzicki, Justyna Napora, Marcin Ceynowa
Institutions: Gdańsk Medical University, Gdańsk University of Technology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7117108559